Trochanteric Bursitis
What is trochanteric bursitis?
Trochanteric bursitis is a common cause of hip pain. It can be a debilitating condition as it tends to persist in time and recur pain subsides. It is due to inflammation of a fluid-filled sac (bursa) around a part of the hip joint known as the greater trochanter.
What causes torchanteric bursitis?
Trochanteric bursitis is more common in women and in middle-aged people, although it can be present on literally anybody. Below are some potential causes of trochanteric bursitis; however, in many cases, the cause is unknown.
- Injury to the hip joint (due to a fall, bumping into things, or lying on one side of the body for extended periods of time)
- Repetitive stress to the hip joint (such as due to climbing, running, standing for extended periods of time)
- Spine-related issues (including scoliosis and lumbar/lower spine arthritis)
- Stress on nearby soft tissue (such as due to leg-length differences leading to poor joint positioning)
- Other medical conditions (including rheumatoid arthritis, gout, psoriasis, thyroid disease, drug reactions, or even infections)
- Previous surgery around the hip joint
- Extra bony growths or mineral deposits in ligaments near the greater trochanter
What are symptoms of torchanteric bursitis?
The main symptom of trochanteric bursitis is pain near the hip joint (on the side), in your thighs or in your buttocks. Initially, this pain is described as “sharp” or “intense;” later, the pain becomes “achy” and can spread to other areas near the hip. Other symptoms can include:
- Pain that is worse at night
- Pain when lying on the affected side
- Pain when you push on the outside portion of the hip joint
- Pain that worsens when you get up from a seated position like from a car or chair
- Pain when walking up stairs
The main issue with trochanteric bursitis is that it can sometimes progress to tearing of the tendons around the bursa. Those tendons are known as the rotator cuff of the hip (gluteus medius and minimus) and can sometimes suffer from the constant inflammation.
How is trochanteric bursitis treated?
Non-Surgical
The initial treatment for trochanteric bursitis does not involve surgery. Many individuals find relief with lifestyle modifications, including:
- Avoiding activities that worsen symptoms
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen and celecoxib, help reduce pain and inflammation
- Using a cane or crutches to help with walking
- Physical therapy to increase hip strength and flexibility. This can include stretching the hip joint, rolling therapy, and/or learning to use ice or heat to relieve pain
- Steroid injections may help with pain relief temporarily (months) or permanently. This involves injecting a corticosteroid (a type of medication that helps reduce inflammation) into the affected bursa.
Surgical
Surgery is rarely needed for trochanteric bursitis. But if the bursa remains painful despite non-surgical options, then a surgeon can go in and clean the affected bursa arthroscopically. This does not affect the hip joint, and the hip can function without this bursa normally.
How is trochanteric bursitis prevented?
Although trochanteric bursitis cannot always be prevented, there are some things you can do to prevent the inflammation and pain from getting worse. These include avoiding activities that put additional stress on the hips, losing weight if appropriate, and maintaining hip strength and flexibility. It’s also important to correct underlying conditions such as leg-length differences and poor posture.
At a Glance
Dr. Jorge Chahla
- Triple fellowship-trained sports medicine surgeon
- Performs over 500 surgeries per year
- Assistant professor of orthopedic surgery at Rush University
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